乳腺癌筛检患者心理需求调查及影响因素分析

Investigation on healthcare and support needs and its influence factors of women with suspected breast cancer

目的探讨疑似乳腺癌患者筛检期间的心理需求及影响因素。方法对283例需做乳腺活检的疑似乳腺癌患者，采用调查表方式了解患者被告知乳腺活检时、活检前及活检确诊后3个阶段的心理需求变化及其影响因素。结果患者被告知乳腺活检时的总需求（27．68±0．53）分，高于诊断后（26．80±0．47）分，其中活检前最高，为（27．93±0．49）分，差异有统计学意义（F=6．48，P〈0．01）；高中或以上教育程度患者诊断前需求得分为（28．83±0．31）分，诊断后得分为（27．06．4±0．46）分；初中或以下教育程度患者诊断前需求得分为（27．04±0．34）分，诊断后得分为（26．92±0．48）分，两组比较差异有统计学意义（t分别为-44．09，～2．40；P〈0．05）。结论乳腺癌筛检患者的心理状况和健康需求随筛检阶段不同而发生变化，其程度与自身情况相关，医护人员应对患者提供个性化的心理干预和健康支持。

Objective To investigate changes in the healthcare and support needs during the diagnostic period, and factors that affect these needs in women with suspected breast cancer. Methods This study used an investigator-developed, self-administered questionnaire to collect data from 283 women on three occasions： notification cation of need for breast biopsy, before biopsy and after diagnosis. Results The total score of need before the patients told breast biopsy was （27.68 0.53 ）, and was higher than that after diagnosis （26.80 ±0. 47 ） and the highest score was that before biopsy, which was （27.93 ±0. 49）, and the difference among the three groups was significant （F = 6. 48, P 〈 0. 01 ） ; needs score before diagnosis was （28.83 ~ 0.31 ） and （27.06 ~ 0.46） after diagnosis in participants whose education background was senior middle school or above; needs score before diagnosis was （ 27.04 ± 0.34 ） and （ 26.92 ± 0.48 ） after diagnosis in participants whose education background was junior high school or below; the differences was significant （t = -44. 09, -2. 40, respectively; P 〈 0. 05 ）. Conclusions Need levels of women with suspected breast cancer vary during the diagnostic period, and are highest before breast biopsy, and related to personal characteristics and cultural context. Therefore, during this period, nursing staff should provide patients and families with culturally sensitive, individualized,, supportive care.